Chain of Survival

Dr Richard Cummins, from Seattle, discovered that if a series of events took place in a set sequence, a heart attack or stroke victim has a greater chance of survival.

These events are known as the 'Chain of Survival'.

Timing is Everything

Time After the Onset:              Chances of Survival:

With every minute:                Chances are reduced by 7-10%

Within 4-6 minutes:              Brain damage and permanent death starts to occur.

After 10 minutes:                   Few attempts at resuscitation succeed

Early Access

The first link in the Chain of Survival is the 999 call.

Can you recognise the symptoms of a heart attack?

• • Uncomfortable pressure, fullness, squeezing or pain in the centre of the chest lasting more than a few minutes

  • Pain spreading to the shoulders, neck or arms

  • Chest discomfort with light headedness, fainting sweating, nausea or shortness of breath

  • Atypical chest pain, stomach or abdominal pain

  • Nausea or dizziness

  • Shortage of breath or difficulty breathing

  • Unexplained anxiety, weakness of fatigue

  • Palpitations, cold sweat or paleness

  Early CPR

Cardiopulmonary resuscitation (CPR) is the second link in the Chain of Survival; it is the link which can buy life-saving time between the first link (Early Access to Emergency Care) and the third link (Early Defibrillation)

During a heart attack the heart twitches irregularly often due to ventricular fibrillation (VF) and cannot pump oxygenated blood efficiently to the brain, lungs and other organs. The victim quickly stops breathing and loses consciousness. Prompt CPR can help sustain life during CPR. The assisted breathing and chest compressions can help oxygenated blood to the persons brain and heart until defibrillation can attempt to restore normal heart pumping.

Early Defibrillation

Defibrillation – the key to survival

Although an important link in the Chain of Survival CPR alone cannot fully resuscitate so early

defibrillation being the third link is therefore the most significant. Defibrillation, the delivery of an electrical shock to the heart muscle can restore normal heart function if it is delivered within minutes of the attack.

When CPR and defibrillation are performed within 8 minutes of an episode the person's chances of survival increases by 20% and if performed within 4 minutes the likelihood of survival increases to 40%.

Early Advanced Care

The fourth link in the Chain of Survival is early advanced care provided by Paramedic and other highly trained emergency service personnel which can include basic life support, defibrillation, administering cardiac drugs and the insertion of endotracheal breathing tubes.

This advanced care can help the heart in VF respond to defibrillation and maintain normal rhythm.